Patient safety is one of the most important challenges facing today's healthcare. There are approximately 2.5 million deaths in the U.S. each year, about a third of which occur in acute care hospitals. Unless there are “do-not-resuscitate” advanced directives in place, patients who die in a hospital most likely have undergone one or more resuscitation attempts known as “code blue.” Code blue is used by hospitals to describe a scenario in which a patient with cardiac or respiratory arrest requires stat medical intervention (i.e., resuscitation). Medical errors occur in healthcare every day. In code blue scenarios, medical errors may be likely to occur, which can cost lives. Common errors in cardiopulmonary resuscitation (CPR) may include slow chest compression rates, shallow chest compression depths, hyperventilation, long pauses in CPR before shock delivery, delivery of electrical defibrillation for nonshockable rhythms, medication errors, failure to follow resuscitation guidelines (e.g., advanced cardiovascular life support (ACLS), pediatric advanced life support (PALS), and/or other guidelines), and/or other errors.
Studies have found conventional paper-based documentation practices of code blue scenarios may be inaccurate, often misreporting intervention delivery times, missing their delivery entirely, and/or making other documentation errors. Paper-based code blue records may commonly have missing time data, include use of multiple timepieces for recording time data during the same event, and convey a wide variation in coherence and precision of clocking devices. For example, the documentation of time in emergency events has been shown to vary significantly, by as much as nineteen minutes, depending on which clocking devices are used. Furthermore, incomplete and inaccurate documentation of code blue scenarios are frequently a source for medicolegal disputes.